No-one is more vulnerable than a new born baby, and more in need of quality care. They are totally dependent on their mothers, who in turn rely on skilled doctors and nurses with working equipment in decent buildings. In Malawi, as in other countries in this region, we urgently need to improve the quality of this care, or place these fragile lives in danger.

In a few days, Malawi alongside eight other countries will be launching a network for improving Quality of Care for Maternal, New-born and Child Health. This is in recognition that the past two decades have been marked by substantive progress in reducing maternal and child deaths. 

Over the past years, governments and development partners across the world have worked tirelessly to improve quality of care, however progress has been uneven with some remote and hard to reach areas left unreached. We have also seen that although there have been increases in access to maternal, new-born and child health services, these have not always led to corresponding improvements in access to quality health services or to an increase in the number of people that voluntarily access health services. 

In Malawi, despite the fact that 89 percent of women deliver at a health facility, quality remains low and too many new-born babies and mothers are dying. In many facilities the infrastructure remains poor. In some, health workers are not trained and lack confidence in caring for new-born infants, especially those who are ill. In other instances, it is the absence of medical practitioners to provide quality care, while in others lack of medical supplies has led to the needless death of babies and mothers.

Despite efforts to reduce death among mothers and babies, the increase in adolescent mothers has also led to an increase in the number of babies that are born premature and with low birth weight. Malawi has the highest premature birth rate in the world, with 18 percent of all babies being born too early and 13 percent with low birth weight.

It is an undeniable fact that Malawi, like many other countries, has made remarkable progress in reducing the number of children who die before their fifth birthday. Child mortality has almost halved since 1990, but as under-five child death rates fall, new-born deaths have increased as a share of overall child mortality.

Every woman and child has a right to quality health care. As we see a rise in the deaths of new-born babies, we need to increase our efforts in providing quality care for pregnant mothers and new-borns.

A reduction in new-born and maternal death requires skilled staff, investments in training and infrastructure but also a deliberate effort to ensure equitable distribution of resources both in urban and hard to reach areas.

It is heart breaking in this day and age to find a mother who has just delivered a baby sleeping on the floor with her new born. It should be unthinkable today to find a facility without the basic medicines that could cure a new-born with infection. It should also be unacceptable to find facilities with unskilled health workers to handle babies born with infection or women who develop infection after delivery.

This is why the establishment of the network on improving Quality of Care for Maternal, New-born and Child Health is so important if Malawi and the rest of the world is to bring new-born and maternal deaths to zero.

The network will give Malawi an opportunity to accelerate and sustain implementation of quality-of-care improvement packages for mothers, new-borns and children. This includes policy shifts and investments leading to women and new-borns receiving the best medical care.

Through the network, we hope to facilitate learning, knowledge sharing, and generation of evidence on quality care. We also hope to strengthen institutions and methods for accountability.

We believe the quality of care network could not have come at a better time. The world collectively has managed to halve the number of women and new-born babies that die during childbirth. We believe with resolve and leadership from the nine governments of Bangladesh, Côte d’Ivoire, Ethiopia, Ghana, India, Malawi, Nigeria, Tanzania and Uganda, we can do more and provide an example for the rest of the world to follow.

This is the time for action, to work together and save the precious lives of our women and new-born children. If we can halve deaths globally, then we can also ensure that every mother and baby receives the quality of care they need to survive and thrive.

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For more information, please contact:

Johannes Wedenig, UNICEF Malawi Representative

Dr Eugene Nyarko, WHO Malawi Representative